Provider Demographics
NPI:1003183526
Name:CITY OF BELLA VISTA AMBULANCE SERVICE
Entity Type:Organization
Organization Name:CITY OF BELLA VISTA AMBULANCE SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:R
Authorized Official - Last Name:SIMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:479-855-8248
Mailing Address - Street 1:103 TOWN CTR W
Mailing Address - Street 2:
Mailing Address - City:BELLA VISTA
Mailing Address - State:AR
Mailing Address - Zip Code:72714-2420
Mailing Address - Country:US
Mailing Address - Phone:479-855-8248
Mailing Address - Fax:479-855-7602
Practice Address - Street 1:103 TOWN CTR W
Practice Address - Street 2:
Practice Address - City:BELLA VISTA
Practice Address - State:AR
Practice Address - Zip Code:72714-2420
Practice Address - Country:US
Practice Address - Phone:479-855-8248
Practice Address - Fax:479-855-7602
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-29
Last Update Date:2011-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1243416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport